Secure healthcare management and communication system

ABSTRACT

A healthcare management and communication system including a central server, home base devices, and portable medical assistant devices (PMAD) providing secure electronic communications among medical facilities and healthcare providers, while ensuring privacy of patient medical records. In an embodiment, the central server communicates with the home base device(s) and the PMAD providing information necessary for a healthcare provider to perform a procedure for a patient. The healthcare communication system provides security for patient information by allowing the healthcare provider to access some basic patient information on the PMAD, including directions to the patient&#39;s house, when the PMAD is in all locations. Only when the PMAD is within a physical proximity to a selected home base device can the healthcare provider access the corresponding patient&#39;s confidential information necessary for the on-site visit. Notes and data recorded during the procedure may be securely transmitted to the central server, updating the patient&#39;s record.

RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/648,612, filed May 29, 2015, which is the U.S. national stageapplication of international application PCT/US2013/075860, filed Dec.17, 2013, which, in turn is a non-provisional of and claims prioritybenefit to U.S. Provisional application No. 61/738,919, filed Dec. 18,2012, all of said applications are incorporated herein by thisreference.

COPYRIGHT NOTICE

©2012-2013 Lillie Coney. A portion of the disclosure of this patentdocument contains material which is subject to copyright protection. Thecopyright owner has no objection to the facsimile reproduction by anyoneof the patent document or the patent disclosure, as it appears in thePatent and Trademark Office patent file or records, but otherwisereserves all copyright rights whatsoever. 37 CFR § 1.71(d).

TECHNICAL FIELD

This invention pertains to healthcare and more specifically relates toimproving delivery of healthcare services while protecting patientprivacy.

BACKGROUND

Medical professionals once visited patients in their homes. As thenumber of patients needing treatment grew, it became more difficult fordoctors or nurses to sit with sick patients in their homes. Advances inmedicine, such as the development of pharmacology, better means ofcapturing medical knowledge to pass to future generations,specialization over general medical practices, and innovations inmedical technology focusing on larger equipment requiring a specialistto operate in physically limited areas (hospitals or testingfacilities), have further accelerated the shift from homecare tohospital care or in-facility treatment.

Due to the growth in the number of patients needing treatment, there areinsufficient numbers of general practitioners as well as insufficientnumbers of specialized doctors to serve the entire population. Thisproblem is further complicated by the concentration of medicalprofessionals in urban and suburban areas and the lack of medicalprofessionals with specialized expertise in rural and certain urbanareas. There are also challenges related to a medical professional'straining keeping pace with the advancement of medical knowledge since,as medical professionals grow older and, in most cases, busier withpatient case loads and administrative duties, it becomes more difficultfor them to acquire new knowledge or learn new skills.

The shortage of qualified doctors has resulted in much of the patientinteraction to be delegated to nurses, nurse practitioners, or homecareproviders. Physicians and hospital administrators are well aware thatthey are not privy to what actually transpires with respect tointeractions and treatment of patients outside their facilities. Theymust rely upon an elaborate model based on the physical collection ofdata through written notes, based upon the observations of the medicalsubordinate professionals who are responsible for the care of patientswhen the doctor is not present. This is an imperfect process forcompletely capturing the medical history of a patientpost-hospitalization, or for patients with chronic conditions.

Managing or preventing chronic medical conditions will be the challengeof the next generation. Medical conditions do exist outside the presenceof the medical profession, and efficiently and accurately monitoringchanges in the medical condition of a patient outside the presence of amedical professional is an ongoing process that has not been addressed.

An efficient system for medical professionals to monitor and be informedof the results of delegated procedures will become an essential tool tomedical professionals who are now in a transformative stage where theymust manage larger patient caseloads, supervise more subordinate medicalstaff, meet the requirements of recordkeeping by government oversightagencies, and, for the well-being of their patients, supervisesubordinate medical staff through oversight, management, review, andassessment.

There remains a need for providing effective and efficient care in anumber of settings without requiring the presence of a physician, whilestill assuring patient medical privacy and keeping the primary physicianinformed. The person or caregiver who visits patients may or may nothave extensive medical training but must provide the first line of carefor patients once the doctors' initial procedures are completed. Forthis reason, knowing as much as possible about what is happening to apatient, and capturing data that may be critical to emergency roompersonnel, physicians' offices, or nurses, will be vital.

SUMMARY OF PREFERRED EMBODIMENTS

The following is a summary of the present disclosure in order to providea basic understanding of some aspects of the disclosure. This summary isnot intended to identify key/critical elements of the disclosure or todelineate the scope of the disclosure. Its sole purpose is to presentsome concepts of the disclosure in a simplified form as a prelude to themore detailed description that is presented later.

This disclosure describes methods and apparatus of a healthcare systemfor transmitting secure electronic communications and patientinformation among medical facilities and a healthcare provider. This maybe achieved through, but is not limited to, the use of a central serverfor storing and transmitting information associated with a procedure tobe performed by a healthcare provider, a home base device for enablingcommunication between a plurality of authorized devices within aselected physical proximity, and a portable medical assistant device foraccessing and displaying received information associated with aprocedure for a patient.

The central server may act as storage unit for a patient's healthinformation and securely transmit a portion of the patient's healthinformation associated with a procedure to be performed by a healthcareprofessional. A physician, or other medical facility staff, may assign aparticular procedure to a specific healthcare professional to beperformed for a patient. The central server may provide information anda selected portion of the patient's health record to one or both of thehome base device and the portable medical assistant device. In anembodiment, the information provided by the central server may comprisea prescription or other instructions for administration of anexamination, test, treatment or other services to a patient. The portionof the patient's health record that is relevant to the services may betransmitted as well.

Electronic communications with authorized devices may be enabled withina selected physical proximity to the home base device. In oneembodiment, the home base device may operate only at two locations,adjacent the central server and at a location where the home base deviceis installed after installation of the home base device, as furtherexplained below.

A portable medical assistant device may receive information associatedwith a patient and display the information on the device. The portablemedical assistant device may have wireless networking capability, andcommunicate with the central server and a home base device. A selectedportion of the information received by the portable medical assistantdevice may be displayed regardless of the location of the portablemedical assistant device, while another portion of the information mayonly be displayed when the portable medical assistant device is withinthe selected physical proximity to the home base device. These features,and others below, support privacy of the patient's recordnotwithstanding the delivery of some healthcare procedures to thepatient at a location away from the physician or hospital.

Additional aspects and advantages of this disclosure will be apparentfrom the following detailed description of preferred embodiments, whichproceeds with reference to the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A is a simplified exemplary block diagram illustrating a centralprogram and management system's service relationships with multiplefacilities.

FIG. 1B is a simplified exemplary block diagram illustrating a securesystem for managing healthcare service delivery in a patient's home.

FIG. 2 illustrates an example of a proximity activation border of a homebase device in an exemplary home setting.

FIG. 3 is an exemplary block diagram illustrating communications among acentral program and management system, a home base device, a portablemedical assistant device and medical assistive devices.

FIG. 4 is an exemplary block diagram illustrating data communicationbetween a central program and management system, a portable medicalassistant device, and a home base device.

FIG. 5 is an exemplary flow chart illustrating operation of a securehealthcare management service.

FIG. 6 is an exemplary flow chart illustrating a process for physicianregistration and assignment of services within a secure healthcaremanagement service.

FIG. 7 is an exemplary flow chart illustrating operation of a portablemedical assistant device by a healthcare professional.

FIG. 8 illustrates use of a secure healthcare management system in amedical facility setting.

FIG. 9 is an exemplary flow chart illustrating setup of a secure emailbox provided by a healthcare service.

FIG. 10 is an exemplary flow chart illustrating message posting andediting on a secure email box.

FIG. 11 is a top view of one example of a home base device cart layout.

FIG. 12 is a side view of one example of a home base device cart layout.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

This disclosure comprises a unique application of technology andprotocols by medical health care providers to promote minimization ofmedical errors, stronger patient privacy, and greater medical careprovider control over the services provided to patients in medicalfacilities and in home settings, assisted living, etc. One advantage isto better accommodate the growing demand for treatment options with thedesire to protect and promote excellent patient outcomes-includingrecovery, privacy, and continuity of care. Patient privacy may rest oncontrol of access to theft medical information. The health datacollection and records keeping system disclosed herein helps assure thatonly those authorized to create, access, or amend patient records arepermitted to do so.

FIG. 1A is a simplified exemplary block diagram illustrating a centralprogram and management system (CPMS) 102 service relationships withmultiple facilities. The CPMS 102 may alternatively comprise a homehealthcare/contract nursing service 104. The CPMS 102 may be owned andoperated by medical facilities, including hospitals or physician'soffices. The home healthcare/contract nursing service 104 may be ownedand operated by a third-party managed service, including private nursingservices. The central program and management system 102 and homehealthcare/contract nursing service 104 may collectively oralternatively be referred to as the CPMS 102. For example, in anembodiment, the functionality of the CPMS may be implemented in or by ahome healthcare/contract nursing service 104.

In an embodiment, a CPMS 102 may be a centralized, fixed computingdevice or logical server that receives requests from physicians or theirdesignees to assign services or treatments for patients to be providedby homecare providers, therapists, or other providers. The CPMS 102 mayprovide adequate securing of a remote computing system that may be thefoundation for creating a link between doctors, hospitals, home healthcare providers, and patients.

The CPMS 102 may act as a communication link among those engaged inhomecare service provided to patients. The CPMS 102 may be responsiblefor enrolling new medical facilities (doctor's offices, hospitals,hospice care facilities, and nursing homes), and allowing the selectionof home health care providers that may provide services to patients.Preferably, a CPMS supports secure near real-time communication amongprimary care facilities or doctors, homecare providers, and healthcarepatients. In some aspects, the CPMS may be configured for logging ofdata for new and existing healthcare patients, engaging patients,managing visits, facilitating direct communication with authorizedmedical professionals, and supporting scoring (e.g. patient surveys,communication with primary medical professionals, overall patientoutcomes) of home health care visits to better inform medicalprofessionals on the effectiveness of the home treatments provided.

In an embodiment, the CPMS 102 may store a patient's medical record foronly a limited period of time. At the end of the limited period of time,the patient's medical record may be pushed to a repository that ismanaged by a medical professional or medical facility. For example,patient record data may be held only during a period when services arebeing provided to the patient using the system, thereby limiting theopportunity for the confidential patient information to be disclosed.

Once the patient's medical record is pushed to the repository, themedical record may be deleted from the CPMS 102 and may not berecoverable, preventing access to confidential patient information onthe PMAD (402 of FIG. 4) after the data has been transferred to CPMS.Preferably, a medical record may be deleted in such a way that it maynot be reconstructed, that it does not damage the sectors on thecomputer server or computer's drive, or as efficiently as possible tominimize the type of damage that can happen when memories areoverwritten repeatedly. Means or methods for deleting the medical recordin a way that may not be reconstructed may require overwriting themedical record in memory. The process may not cause additional secondaryproblems with the memory may be used. This may make the CPMS 102unattractive to external threats, attempts to breach, and preventvulnerability to insider threats since the data retained on the CPMS 102may not be valuable for theft and the security features may besufficiently incorporated to effectively protect the data from misuseand abuse. In some cases, the CPMS 102 or some or all of its datastorage capacity may be provisioned in remote, third-party facilities(aka “the Cloud”). In such cases, suitable agreements must be in forceto ensure data security and destruction when directed.

In one embodiment, the CPMS 102 may be configured to facilitate securecommunication among medical facilities 106 and home healthcareresidential locations 110, as illustrated by the solid lines in 100,such that confidential medical information may not be accessed byunauthorized individuals during transmission of the information. Themedical facilities 106 may comprise one or more medical facilities,doctor's offices, hospitals, hospice care facilities, nursing homes, orother facilities that may store a patient's medical record.

In other embodiments, additional or alternative communication links maybe provided by the CPMS 102, as illustrated by non-solid lines in 100,allowing the CPMS 102 to service multiple facilities. Thesecommunication links may include links among the CPMS 102 and hospitals108, among the CPMS and assisted living rehab/hospice 112, and othersimilar communication links.

In further embodiments, there may exist a flow of patients and/or amovement of medical records among facilities, as illustrated by dottedlines in 100. As illustrated in 100, the flow of patients and/or medicalrecords may flow (a) between the medical facilities 106 and thehospitals 108; (b) between the medical facilities 106 and an assistedliving rehab/hospice 112; and/or (c) between the CPMS and hospital 108or other similar flows of patients and/or medical records. These flowsare described further below with regard to the processes of 500 and 600.

FIG. 1B is a simplified exemplary block diagram illustrating a systemfor managing healthcare service delivery in a patient's home. Acommunication link may be made among patient homes 152 and the CPMS 102or among patient homes 152 and a home healthcare/contract nursingservice 104.

A home base device (HBD) 154 may be placed in a patient's home among thepatient homes 152. The HBD 154 may be placed anywhere in the patient'shome where it may communicate with a portable medical assistant device(PMAD) (402 of FIG. 4), such that the device may be placed in a discretelocation. Placing the device in a discrete location may prevent visitorsto recognizing that the patient has a condition or what the conditionmay be.

The HBD 154 may operate as one end of the communication link between theCPMS 102 and the patient's home. The HBD 154 preferably is configured tocommunicate with three types of devices: the CPMS 102, the PMAD (402 ofFIG. 4), and medical assistive devices (304 of FIG. 3). The HBD 154 mayassure that only the medical information necessary for a specifictreatment or therapy is accessed by the PMAD (402 of FIG. 4).

The HBD 154 may require initialization and HBD 154 may wirelesslycommunicate with the CPMS 102 about its state to activate and run in afixed geographic location. The HBD 154 may have its own unique IPaddress information and/or its own unique MAC address information. Inone embodiment, the HBD 154 may operate at only two fixed locations: thelocation of the CPMS 102 and the location where the HBD 154 isinitialized. Location may be determined by GPS, Bluetooth® short-rangewireless ad hoc network, wireless telecommunication network, or othermeans now known or later developed.

FIG. 2 illustrates an example of a proximity activation border 206 of aHBD 154 in an exemplary home setting. A floor layout 204 of a patient'shome 202 is illustrated with a HBD 154 installed. A proximity activationborder 206 may be limited to a selected physical proximity from a HBD154, therefore preventing access of confidential patient information onthe PMAD (402 of FIG. 4) elsewhere.

The proximity activation border 206 may be used to enable access to aportion of information stored on a PMAD (402 of FIG. 4) when the PMAD(402 of FIG. 4) is located physically within the proximity activationborder 206. Conversely, the PMAD should be configured to disallow accessto selected information, for example, patient health records, when thePMAD (402 of FIG. 4) is located outside of the proximity activationborder. For example, patients' records may be stored in the PMAD (402 ofFIG. 4) by the CPMS 102, and secured there, so they are inaccessibleunless and until the PMAD (402 of FIG. 4) is carried to a locationwithin the defined proximity activation border 206, limiting theopportunity to misappropriate the patient's confidential information tothe confines of the proximity activation border 206. Thus, for example,a healthcare provider may carry the PMAD (402 of FIG. 4) with her to apatient's home to provide assigned services. While the PMAD (402 of FIG.4) is at the healthcare provider's home, or in her car, or elsewhere,the patient record is secure. Only after arrival at the patient's home(inside the proximity activation border 206) is the record accessible onthe PMAD (402 of FIG. 4). Further, patient record updates entered by thehealthcare provider will be secured as the device leaves the premises.The proximity activation border 206 may also allow communication amongthe HBD 154, the medical assistive devices 304, and the environmentsensors 306 within the proximity activation border 206 as furtherdescribed below.

FIG. 3 is an exemplary block diagram illustrating communications among aCPMS 102, a HBD 154, a PMAD (402 of FIG. 4), and medical assistivedevices 304. Communication may be two-way among the devices when thedevices are located within the proximity activation border 206 of theHBD 154. The HBD 154 may be configured for one-way communication toreceive input from linked devices, which may comprise, for example,environment sensors 306, medical assistive devices 304, and otherdevices 312 associated with a patient. In this way, the HBD 154 can beused to collect data at various times, even in the absence of ahealthcare provider. It can upload collected data to the CPMS 102 whenavailable.

FIG. 3 illustrates one embodiment where a tablet computer 302 may beused as the authorized PMAD (402 of FIG. 4). This may be realized byhaving a suitable application program installed on the tablet. Thetablet, in some cases, may also provide wireless telecommunications. Theinstalled app may limit functionality of the tablet outside of theproximity activation border 206, such as to protect against unauthorizedaccess of a patient's confidential information. The authorized PMAD (402of FIG. 4) is a device that may be issued to a healthcare provider orother user assigned to provide a service for a patient. The authorizedPMAD (402 of FIG. 4) may also be required to meet certain credentialsfor communication.

The HBD 154 may be configured to communicate with the tablet 302, actingas the authorized PMAD (402 of FIG. 4), the medical assistive devices304, and the environment sensors 306, as shown by broken lines in 300,when the devices are located within the proximity activation border 206.The HBD 154 may be further configured to not communicate with deviceswithin the proximity activation border that are not the authorized PMAD(402 of FIG. 4), the medical assistive devices 304, and the environmentsensors 306, such that unauthorized devices may not be able to access apatient's confidential information. By way of example, laptop 310 andother device 312 illustrated in 300 may not communicate with the HBD 154in the illustrated embodiment.

The CPMS 102 may be configured to communicate with the HBD 154, theauthorized PMAD (402 of FIG. 4), and other facilities 316 across theinternet 318, telecom network 314, or similar communication networks. Inother embodiments, the CPMS 102 may be able to communicate with otherdevices within a healthcare home area network that is limited tocommunication within the proximity activation border 206.

Communication among the devices preferably employs strong encryptionkeys and remote access controls for devices that are paired to recognizeeach other, allowing a secure connection among the devices. The devicesconfigured to operate within the proximity activation border 206 may bedesigned to close communication when one or both of the paired devicesare not within the proximity activation border 206. Attempts to breachany of the devices, or changes in the patient's condition or thephysical environment that may indicate unsafe conditions may be reportedto the CPMS 102, other facilities 316, the HBD 154, the PMAD 402,emergency services (not pictured), or any other device or facility thatcomprises a part of the system.

The HBD 154 may be installed in a patient's home, a hospital room, anassisted living rehab/hospice room, or any other location where apatient may currently reside. The HBD 154 may not require that it bevisible to anyone in the home or the room. The HBD 154 may be requiredto be placed in a location where the PMAD (402 of FIG. 4) may be able tocommunicate with the HBD 154.

Once installed, the HBD 154 may act as simple wireless base transmittercommunicating unique IP address and MAC address information. The rangeof the HBD 154 transmitter may be configured to extend to a selectedphysical proximity, represented by the proximity activation border 206.

The HBD 154 may be configured to only communicate with three devices:the PMAD (402 of FIG. 4), the medical assistive devices 304 (includingthe environment sensors 306), and the CPMS 102. This may help to preventother devices from accessing a patient's confidential information.

The HBD 154 may further be configured to include limited audiocapabilities. The audio capabilities may be able to play pre-programmedterms or phrases that may signify that the patient should take anaction. For example, a term or phrase may signify that the patient needsto have a banana to increase potassium. The terms or phrases may beselected with a purpose towards discreteness. For example, the devicemay suggest a banana for snack that does not disclose why thatparticular snack was suggested, where the patient may be aware of theircondition that initiates the term or phrase. There may be other discreteprogramming terms or phrases for reminders to take medication that donot use the word medication. There may also be discreet reminders abouttaking in fluids that may be casual enough and nondirective enough tohelp the patient remember to have a glass of water. The terms or phrasesmay be programmed to signify almost any reminder, including to eat ameal, to drink water, to take a rest break, to go to the bathroom, takea bath, and to change clothes.

The HBD 154 may further be configured to alert the patient or healthcareprovider to changes in conditions in a discreet way. The alert may betransmitted to any device or multiple devices within the proximityactivation border 206 of the HBD 154 that may wirelessly communicatewith the HBD 154. In one embodiment, the alert may be transmitted to acell phone or smart phone 308 containing an app that will alert in adiscreet way that may not disclose any sensitive information. The cellphone or smart phone 308 may display terms, phrases, or otherinformation related to the alert, allowing the patient or the homecareprovider to take appropriate action.

The CMPS 102 may be a centralized fixed computing device that receivesrequests from physicians or their designees to assign treatment forpatients to be provided by healthcare providers. In one embodiment, theCPMS 102 may be configured to communicate with the HBD 154, the PMAD(402 of FIG. 4), or other facilities 316. The CPMS may connect throughthe internet 318 or telecom network 314, among other connection typescapable of providing real-time or near real-time communication, suchthat a physician may communicate with the healthcare provider inreal-time or near real-time while the healthcare provider is with thepatient.

The PMAD (402 of FIG. 4) may comprise a smart phone 308, a laptop 310, atablet 302, or any other device 312 which may maintain communicationlinks with the HBD 154 or the CPMS 102, or both. In one embodiment, thePMAD (402 of FIG. 4) may be further configured to maintain communicationlinks with medical assistive devices 304, which may comprise environmentsensors 306.

The PMAD (402 of FIG. 4) may be issued to a healthcare provider or anyother user assigned a service to perform for a patient. The PMAD (402 ofFIG. 4) may contain the physician designation code; the medical servicecode(s) for the care to be provided by the physician, and turn-by-turndirections to the patient's location, such that the healthcare providermay know what procedure she is providing to the patient and where thepatient resides. The address may not be displayed on the PMAD (402 ofFIG. 4). The salutation and the patient's last name may be provided onthe PMAD (402 of FIG. 4).

When turned on, the healthcare provider, or other user issued the PMAD(402 of FIG. 4), may enter a code for a new patient and a designationgenerated for the patient to trigger a download of informationassociated with the patient to the PMAD (402 of FIG. 4). The PMAD (402of FIG. 4) may display a first portion of the downloaded informationwhen the PMAD is located at any location. The first portion of thedownloaded information may include turn-by-turn directions to thepatient's location, the salutation of the patient, and the patient'slast name.

The PMAD (402 of FIG. 4) may be configured to display a second portionof the downloaded information only when the PMAD (402 of FIG. 4) iswithin the proximity activation border 206. In one embodiment, an accesscode may be required to be entered into the PMAD (402 of FIG. 4) beforethe second portion of the downloaded information may be displayed. Thesecond portion of the downloaded information may comprise anyinformation necessary for the healthcare provider, or other user, tocomplete the assigned service for the patient.

The PMAD (402 of FIG. 4) may be configured with a wireless feature. Thewireless feature may be networked with other medical devices to collectdata and record data in a passive fashion while health care provider ismaking input. The collected and recorded data may be provided by themedical assistive devices 304, the environment sensors 306, or the HBD154, among any other device that may collect data and may be configuredto communicate data wirelessly.

The PMAD (402 of FIG. 4) may open an ATM connection or encrypted path tothe CPMS 102 or the other facilities 316, which may include medicalfacilities, doctor's offices, hospitals, hospice care, nursing homes,and any other facility that may comprise a part of the system, alertingthem that the healthcare provider is with a patient. The PMAD (402 ofFIG. 4) may also communicate contact information for the healthcareprovider (video conferencing, text, IM, e-mail or cell phone number)across the ATM connection or encrypted path. This may allow thephysician, or other authorized personnel, to communicate with thehealthcare provider while she is with the patient.

The medical assistive devices 304 may link to the HBD 154 when withinthe healthcare home area network, which the range of the network extendsto the proximity activation border 206. The medical assistive devices304 may collect diagnostic information on patients, including while thepatients are not in the presence of a physician, healthcare provider, orother authorized personnel. The medical assistive devices 304 mayinclude insulin pumps, diagnostic devices, blood pressure detectiondevices, temperature registering devices, or applications and diabetesmanagement technology. The medical assistive devices may furthercomprise new medical assistive technologies like readings from homeexercise technology, pulse and heart monitoring devices, motiondetectors, room temperature registers, environment sensors 306, and anyother type of device that may collect diagnostic information on patientsor their surroundings.

In one embodiment, devices that report physiological states of a patientmay be disengaged for a short period of time, allowing a patient to haveprivacy from the data collection. These devices comprise the environmentsensors 306 and the medical assistive devices 304. In a furtherembodiment, notations may be provided to the CPMS by any of the deviceswithin the proximity activation border 206.

FIG. 4 is an exemplary block diagram illustrating data communicationbetween a CPMS 102, a PMAD 402, and a HBD 154. Communication may occuramong the CPMS 102, the PMAD 402, and the HBD 154, as illustrated by thebroken lines in 400.

Block 404 illustrates properties of the PMAD 402 and information thatmay be stored by the PMAD 402. The PMAD 408 may store patient IDs andmedical files. In further embodiments, the PMAD 408 may store aphysician designation code, a medical service code(s) for the care to beprovided by the homecare provider, turn-by-turn directions to thepatient's location, a salutation for the patient, and the patient's lastname, The PMAD 408 may also store encrypted data on a healthcareprovider's assignment for an entire day. Further, the PMAD 408 may storeone or more records on unique patients including the patient's healthinformation related to the treatment the healthcare provider shouldprovide, treatments, medical services the healthcare provider shouldprovide and test or report data the healthcare provider or the wirelessfeatures of the PMAD 408 should collect. In some embodiments, the PMAD408 may be configured with a wireless component and geo-locationcontrol.

Block 406 illustrates properties of the HBD 154 and some types ofinformation that may be stored by the HBD 154. The HBD 154 may operateas data storage. The HBD 154 may be configured with proximity detectionand pairing, interface medical assistive devices 304, data collection,environmental monitoring, bed sensors, and the ability to contactemergency. The HBD 154 may be able to alert healthcare providers ofserious or life threatening situations associated with a patient andrelay information in near real-time through a secure encryptedcommunication link to the CPMS 102, such that a patient may obtainemergency care even when she is not in a situation to contact emergencyservices.

FIG. 5 is an exemplary flow chart illustrating operation of a securehealthcare management service. A secure communication link may existamong the CPMS 102 and a physical or medical facility. The securecommunication link may allow a physical or medical facility to receivereports from the CPMS 102.

A physician or other authorized medical personnel (collectively referredto as ‘physician’) may use the secure communication link to performphysician registration 502 with the CPMS 102. The physician maydesignate therapists, pharmacies, and other preferred medical supportprofessionals that they may use to assist patients. In response toregistration 502, the CPMS 102 may send a subscription to thephysician's office. The subscription may be controlled by securityprotocols to assure that information is received by an authorized personin the physician's office.

In step 504, a physician registered with the CPMS 102 may order servicefor a patient. The process of ordering service may comprise theselecting of a healthcare provider to perform the desired service forthe patient.

The physician completes the steps comprising step 506 to order servicefor the patient. The physician will log on to their account with theCPMS 102. The physician may register a patient for care, designate thetype of service needed, and provide other details. A medical physiciancoding system may be used by the system to assure that patient andtreatment instructions are clear. The physician may also record amessage that may be used to alert the patient in advance of theappointment.

The request for service and other designated information may betransmitted to the selected healthcare provider. In step 520, thehealthcare provider may verify the authority of the physician orderingthe service and/or the healthcare provider's capability to perform therequested service. If the healthcare provider determines that thephysician ordering the service does not have authority to do so or thatthe healthcare provider is unable to perform the requested service, theprocess may revert back to step 506 where the physician will be requiredto repeat the process of ordering service with a different healthcareprovider selected. Otherwise, the process may continue to step 522.

In step 522, prior to the medical service provider's visit, a recordedmessage from the physician's office may be received by the patientalerting them to the pending visit by the healthcare provider, when thehealthcare provider will arrive, and providing a call back number forthe healthcare provider. The message may include the name of thehealthcare provider and the entity the healthcare provider will berepresenting, as well as the physician's or medical facility's name andcontact information.

The HBD 154 may alert the patient with the message and a physicalindicator that the patient should expect a healthcare visit. In responseto the alert of a pending visit by the healthcare provider, the patientmay cancel, request rescheduling or confirm the appointment, shown instep 524.

If the appointment is cancelled or a rescheduling appointment request isinitiated, shown in step 514, the physician may be alerted using aunique patient medical record designation generated by the CPMS 102,shown in step 508. The patient's request may be communicated to thephysician through a message that may only contain the unique patientidentifier generated by the CPMS 102. The physician may be required toaccess their account on the CPMS 102 to see the details of the patientrequest to protect the confidentiality of the patient's information.

If the patient confirms the appointment, or does not object or cancelthe appointment, the HBD 154 may be programmed by the CPMS 102 with onlythe amount and type of information needed for the pending healthcarevisit in step 526, limiting the amount of information that may beobtained outside of the medical facility setting. The HBD 154 may have aprogram control that requires a complete wipe (overwriting theinformation sufficiently to assure the data may not be recovered) beforeit can be reassigned to a new patient. Once the HBD 154 is programmed,the healthcare provider may take it to the residence of the patient, orother intended location of installation.

The healthcare provider may have a PMAD 404 with enabled wirelessnetworking capability. In step 528, the healthcare provider may turn onthe PMAD 404 and enter a patient code and patient designation, which maytrigger the download of information associated with that patient and theservice to be provided from the CPMS 102. The downloaded information maycontain directions to the patient's residence and instructionsconcerning the service to be provided.

In step 530, it is determined whether the patient is a new patient. Ifthe patient is a new patient, the flow continues to step 532. If not,the flow continues to step 534.

In step 532, the HBD 154 may be delivered and installed. The HBD 154 maybe installed anywhere in the patient's residence that may allowcommunication between the HBD 154 and the PMAD 402. The HBD 154 mayoperate as a simple wireless base transmitter, with a selected limitedrange, communicating a unique IP address and MAC address information.

The HBD 154 may initialize by communicating with the CPMS 102 about itsstate to activate and run in a fixed geographic location. Onceinitialized, the HBD 154 may function in only two fixed geographiclocations, the location of the CPMS 102 and the fixed geographiclocation where the HBD 154 was initialized. Once installed andinitialized, the HBD 154 may only be reset by bringing the HBD 154 backto a management device (not shown), thereby ensuring that the HBD 154 isnot transferred to a different location while maintaining the originalpatient's confidential information on the HBD 154.

In step 532, it is determined whether the PMAD 402 is within theproximity activation border 206 of the HBD 154. If the PMAD 402 iswithin the proximity activation border 206, the flow will continue tostep 518. If not, the flow will remain in step 534 until the conditionis satisfied.

In step 518, the healthcare provider may enter an access code into thePMAD 402 and a medical service record associated with the base device,the portion of the patient's medical record associated with theprocedure stored on the PMAD 402, and other information stored on thePMAD 402 pertaining to the patient that were previously inaccessible maybecome accessible. For security of the confidential information of apatient, the PMAD 402 may be configured to allow access to medicalrecords and information associated with only one patient at a time. Oncea patient's medical record is accessed, the healthcare provider may needto complete the task for the patient or pause and close the session(which can be resumed later when the access code is reentered and theportable device is within the specified range of the base device) priorto accessing another patient's medical record.

In step 516, the healthcare provider performs the ordered services forthe patient. Instructions for the service may be provided on the PMAD402 to provide guidance to the healthcare provider on how to perform theservice.

In step 512, the healthcare provider completes the services. Thehealthcare provider may complete the service by entering the requireddata for the service into the PMAD 402 and storing the data. To assurethat a complete record is maintained over time, no deletion of data fromthe PMAD 402 may be performed.

In step 510, the patient's medical record is updated on the CPMS 102.The data stored on the PMAD 402 may be uploaded to the CPMS 102 at theend of the day, or at another scheduled time period. In order to protectthe security of the transferred information, a secure communication linkto transfer the data may be opened with the physician's office,hospital, nursing home, or hospice facility, if the facility has adevice for this purpose. Alternatively, the data may be recorded in anaccount on the CPMS 102, which may send a message regarding updates orchanges to the physician's office, hospital, nursing home, or hospicefacility.

Once the data on the PMAD 402 is uploaded to the CPMS 102, the copy ofthe data remaining on the PMAD 402 may be deleted. The deletion may bemade such that the data is unrecoverable. By making the dataunrecoverable, the PMAD 402 may not be attractive for external threatsto an attempt to breach nor to insider threats.

In step 508, notification may be provided to the physician requestingthe service that the service has been completed, if the healthcareprovider has completed the service and uploaded the data from the PMAD402. Alternatively, if the patient requested rescheduling orcancellation of a scheduled healthcare appointment, the physician may beinformed that the patient has made a request. By providing thisnotification the physician ordering the service may be aware of theprogress or results of the ordered service shortly after information isuploaded to the CPMS 102.

FIG. 6 is an exemplary flow chart illustrating a process for physicianregistration and assignment of services within a secure healthcaremanagement service.

In step 602, the physician registers with the healthcare serviceestablishing an account for the physician with the service. Thephysician may designate therapists, pharmacies, and/or other preferredmedical support professionals, therein producing a list of healthcareproviders from which the physician may select a healthcare provider towhich to assign a service to be performed for a patient.

In step 604, the physician's office may receive a subscription from thehealthcare service. The subscription may be controlled by securityprotocols to assure that the information is received by an authorizedperson in the physician's office.

In step 606, the physician may log on to the account using thesubscription information provided in step 604. Once logged on to thehealthcare service, the physician may be able to designate a service tobe performed, update the list of healthcare providers, receive resultsof services performed by healthcare providers for patients, and receiverequests to alter a healthcare provider visit schedule, among any otheractivities that the service may provide.

In step 608, the physician may register a patient for care provided bythe service. Registering a patient for care may comprise designating thetype of service to be performed for the patient and designating otherdetails provided by the server, including which portion of a patient'smedical record may be uploaded to the PMAD 402 to assist the healthcareprovider in performing the service or instructions for performing theservice. A medical physician coding system may be used by the service toassure that the type of service and associated instructions are clear.

In step 610, the physician may assign the service to be performed to aparticular healthcare provider. The healthcare provider may be selectedfrom the list of healthcare providers created upon registration with thesystem for ease of assignment by the physician. Alternatively, ahealthcare provider not on the list of healthcare providers created uponregistration with the system may be assigned the service and, further,the healthcare provider may be added to the list of healthcare providersstored on the server.

In step 612, a notice of the service assignment made by the physicianmay be provided to the PMAD 402 to inform the healthcare provider of theassignment. This notice may comprise details on the assigned service andinstructions for completing the assigned service, such that thehealthcare provider may verify his competence in performing the service.The notice may also comprise directions to the patient's location, and asalutation and surname of the patient such that the healthcare providermay determine the location of the patient and be able to address thepatient when arriving at the patient's location.

FIG. 7 is an exemplary flow chart illustrating operation of a PMAD 402by a healthcare professional. In step 702, the healthcare provider mayreceive notice of an assignment for service made by a physician on thePMAD 402. The notification may comprise directions to the patient'slocation. The directions may comprise turn-by-turn directions to thepatient's location without providing an address for the patient'slocation, thereby allowing for the least amount of identifyinginformation of the patient to be provided. The notification may comprisethe patient's salutation and last name to assist the healthcare providerin communication with the patient. In addition, the notification maycomprise details and instructions pertaining to the service for thepatient, such that the healthcare provider may verify that the provideris able to perform the service. If the healthcare provider is unable toperform the service, the healthcare provider may send notification ofsuch to the physician, thereby allowing the physician to assign theservice to a different healthcare provider.

In step 704, the healthcare provider may input a code associated withthe patient and a generated designation for the patient triggering thedownload of information associated with the patient and the assignedservice. The input requirements may verify that the authorizedhealthcare provider is the only individual whom may download what may beconfidential information to the PMAD 402. The information, or at least aportion of the information, downloaded to the PMAD 402 may not beaccessible on the PMAD 402 until the system determines that the PMAD 402is within the proximity activation border 206 of the HBD 154.

In step 706, the system may determine whether the PMAD 402 is within theproximity activation border 206. This determination may provide,possibly in combination with other criteria, the benefit of allowing aportion of the information on the PMAD 402 to be accessed within theproximity activation border 206. If the PMAD 402 is not within theproximity activation border 206, the flow may continue to step 708 wherethe system waits for the PMAD 402 to be within the proximity activationborder 206 before the healthcare provider can continue with the serviceprocess. If the PMAD 402 is within the proximity activation border 206,the flow may continue to step 710.

In step 710, the healthcare provider may access the patient record, andany other information designated to only be accessible within theproximity activation border 206, by inputting the physician home carecode and patient code into the PMAD 402. Inputting the codes into thePMAD 402 will allow the healthcare provider to access a portion of theinformation downloaded to the PMAD 402 in step 704 that was notpreviously accessible. This step may provide the additional security ofverifying that the assigned healthcare provider is the only individualwho may access the information.

If the PMAD 402 exits the proximity activation border 206 whileinformation made accessible in step 710 is currently being accessed, thePMAD 402 may issue an alert and warning that the patient session isending. The alert may be audible, such as to alert the healthcareprovider that she is leaving the proximity activation border 206. Forsecurity of the patient's information, the warning and alert may notmention the name of the patient. If the PMAD 402 does not move backwithin the proximity activation border 206 within a short time of thewarning, the HBD 154 and the PMAD 402 will close the link between thedevices. Additionally, an auto log out command may be run on the PMAD402, preventing the healthcare provider from accessing the informationmade accessible in step 710. The files being accessed when the PMAD 402exits the proximity activation border 206 may be stored in a preliminarymode. After auto log out, when the PMAD 402 enters the proximityactivation border 206 of any HBD 154, the PMAD 402 may display theunsaved data and provide the healthcare provider an opportunity to savethe data. In order to view the unsaved data when within the proximityactivation border 206, the healthcare provider may be required to inputan initialization code and a joint authentication of an assignedpatient's HBD 154. The PMAD 402 may be configured to not allow access orprocessing of another patient's data until the unsaved data is eithersaved or placed in a form hold.

Step 712 may provide the additional functionality of notifying thephysician when the healthcare provider is within the proximityactivation border 206. The notification may include contact informationfor the healthcare provider, comprising video conferencing, textmessaging, instant messaging, e-mail, or cell phone number. The PMAD 402may open an ATM connection or encrypted path to the physician ordesignated medical facility. Step 712 may allow the physician tocommunicate with healthcare provider while the healthcare provider isproviding the service for the patient. The PMAD 402 may have audio andvisual features that may alert the healthcare provider of communicationfrom the physician or designated medical facility. The physician mayaccess the medical service provider's visit and offer additionalrequests for further engagement with the patient. The physician's imagemay also be displayed on the PMAD 402 and the physician may be able toaudibly communicate with the healthcare provider over the PMAD 402.

In step 714, the healthcare provider has completed the service andinputs the data produced during the service into the PMAD 402. To verifythat the record of the service is complete, once data is input into thePMAD 402, the data may not be deleted. The data will be stored on thePMAD 402 until a connection is established with the CPMS 102 allowingthe data to be uploaded to the CPMS 102. The upload may be scheduled tooccur at certain times, at certain time intervals, or upon certainoccurrences.

In step 716, the healthcare provider completes the session on the PMAD402. The PMAD 402 may provide for confirmation by the healthcareprovider prior to completion of the session, thereby allowing thehealthcare provider to verify that all data associated with the servicesession has been entered into the PMAD 402 prior to upload of theinformation.

In step 718, the PMAD 402 transmits the input data to the CPMS 102. Asecure communication link may be established between the PMAD 402 andthe CPMS 102 to provide for maximum security of the patient'sinformation. The input data may then be stored in an account on the CPMS102 to be accessed by the physician. Alternatively, a securecommunication link may be opened among the PMAD 402, the CPMS 102, and adesignated medical facility allowing the data to be uploaded directly toa device at the medical facility.

In step 720, the patient record and any information associated with thepatient is removed from the PMAD 402. For the security of the patientrecord and information, the record and information may be removed insuch a way that it is unrecoverable. The record and information may bemade unrecoverable by overwriting the data or any other technique nowknown or later developed that may make electronically stored dataunrecoverable. The technique for making the data unrecoverable may beselected to be the technique that causes the least degradation or damageto a storage device.

FIG. 8 illustrates use of a secure healthcare management system in amedical facility setting. As shown, the HBD 154 may be installed withina patient's room within a medical facility. The HBD 154 may beconfigured such that the proximity activation border 206 of the HBD 154extends only to the borders of the patient's room 802, thereby allowingaccess to a portion of the information uploaded to the PMAD 402 to onlybe accessible within the patient's room.

The PMAD 402 may be stored in a location separate from the patient'sroom 802, such as by a nurse station as shown. A nurse, or otherauthorized healthcare provider, may then obtain the PMAD 402 from thestorage location and use directions provided by the PMAD 402 to take thePMAD 402 to the patient's room 802 along a path 804 provided by the PMAD402, allowing for the PMAD 402 to be activated within the patient's room802. This setup may provide for greater security of the patient'sinformation by making a portion of the information only accessiblewithin the patient's room 802.

FIG. 9 is an exemplary flow chart illustrating setup of a secure emailbox provided by a healthcare service. The secure email box may providefor the secure transfer of data between users of the email box system.The users of the email box system may comprise physicians, patients,and/or healthcare providers. In one embodiment, the physician may act asa first user registering the secure email box and the physician maydesignate patients and/or healthcare providers as secondary users,allowing the secondary users access to the secure email box.

The secure email box may feature voice and video conferencing, notes,messages, reminders, and appointments, among other communicationmethods. The communications across the email box system may utilize128-bit encryption or better. Due to the high levels of security and thereal-time communication available through the secure email box system,the system may be ideal for transfer of confidential documents, such asa patient's medical records, among the physician, the patient, and thehealthcare providers.

In step 902, a first user registers an email box. The first user mayestablish a network among multiple users to share data. The first usermay be required to create a password key and a question with a secretanswer that may provide further security to access of the email box.

In step 904, the first user may designate a list of secondary usersallowed to access the email box. This may allow the first user toinitially limit the users that may view any data placed into the emailbox. Additionally, the first user may set permissions for each secondaryuser. The permissions may comprise ability to read data placed in theemail box, ability to write data to the email box, and the ability tomodify data placed in the email box by other users.

In step 906, the email system may generate a set number of unique keysthat may open the email box. The number of unique keys generated may bebased on the number requested by the first user, thereby providing onlyaccess to the users that the first user provides the keys to. The firstuser may be assigned one of the unique keys and secondary usersdesignated by the first user may each be assigned one of the otherunique keys. The unique keys may be geo-location-linked anddevice-linked to maximize security. The unique keys may be stored on aportable device, comprising a thumb drive, a laptop, or any otherportable device now known or later developed. Further, the email systemmay require the first user to create an access code, which may bedistributed to the secondary users along with the unique keys as furthersecurity that only intended secondary users receive access to the emailbox.

In step 908, the first user provides the access code to the secondaryusers. The access code may be required in the process of the secondaryusers in setting up each secondary user's individual account.

In step 910, each secondary user uses the access code to register foraccess to the email box. By entering the access code, the secondary userverifies that the secondary user was intended to be granted access tothe email box. Upon entry of the access code, the secondary user may begreeted by a welcome message requesting that the secondary user answer aquestion correctly before being granted access to the email box. Thesecondary user may also be assigned one of the unique keys generated bythe email box system along with a log in.

In step 912, notice is provided to the first user when each secondaryuser registers an account. This may provide the first user withknowledge of who may currently access data on the email server.Additionally, confirmation of registration may be sent to the secondaryuser registering an email box account.

In step 914, the email box system may generate a watermark for each userwith registered key access. The watermark may be used to signify whichuser posted which data to the email box.

FIG. 10 is an exemplary flow chart illustrating message posting andediting on a secure email box. The example illustrates functionalitythat the email box system may possess when a first user posts a messagein the email box.

In step 1002, a first user posts a message to the email box. The firstuser may designate secondary users that may access the message. Theability to designate which secondary users may access the message allowsthe first user to exclude secondary users from seeing the message,thereby providing security to the information within the message. Once amessage has been posted, the message may be configured such that noadditional secondary users may be designated to access the messageunless all users designated to view the message at the time of proposalof the additional secondary user agree that the additional secondaryuser may be designated to view the message.

In step 1004, the designated secondary users may receive notice of thenew message posted by the first user. This provides the secondary userswith knowledge of any new messages that may be posted.

In step 1006, a designated secondary user may view the message. Thesecondary user may access the message by accessing the secondary user'sindividual email box using the secondary user's pass code. The email boxmay store the digital signature of all users who have accessed themessage. The message may be watermarked with the date and time stampsfor users who have accessed the message as well as noting the locationof the access.

In step 1008, the email box may be configured to provide notice to thefirst user when any secondary user views the message, thereby allowingthe first user to verify that every secondary user required to view themessage did so.

In step 1010, the designated secondary user may edit the message. Anyedits to the message by the designated secondary user may be tracked andthe tracking may associate the edits with the particular designatedsecondary user. This allows the first user and all other designatedsecondary users to view who made the edits to the message. Additionally,an edit to the message may comprise a reply to the message. Any repliesto a message may create a new thread. The ability to edit messages maybe utilized by a healthcare provider to edit a patient's medical recordafter completing service for a patient when if a physician posts thepatient's medical record in the email box.

In step 1012, the first user and all designated secondary users mayconfirm the edits to the message. The confirmation process may beginwith the user producing the edits confirming that the edits are a finaldraft. The message may then be updated to incorporate the edits as trackchanges. Each first user and designated secondary user may then affirmthe edits. Once edits are affirmed by every user with access to themessage, the track changes are removed from the message producing a newmessage incorporating the track changes.

FIG. 11 is a top view of one example of a home base device cart layout.The home base device cart 1100 may be used to allow the HBD 154 tobecome mobile within a specified area. The home base device cart 1100may be configured such that the cart may remain within a selected rangeof a locator control device, thereby staying within the range of apatient's basic vocal commands. The locator control device may be wornby a patient and may comprise jewelry, a watch, a pendent, a necklace, abracelet, or any other object that may be worn by a patient. The homebase device cart 1100 may be configured to avoid the path of individualswithin proximity to the cart and may be configured to move amonglocations that are hidden from sight.

The home base device cart 1100 may be configured with basic voicefunctions, such that the cart may communicate with a patient.Additionally, the home base device cart 1100 may be configured toreceive basic verbal commands from a patient, including commands tocontact emergency medical services. The ability to communicate with thepatient and receive commands will help the home base device cart 1100 tobetter serve a patient by providing verbal reminders to a patient. Thevoice functions may also be configured to provide entertainment optionsfor the patient, comprising jokes, music, news, digital books, andrecorded speeches, among other types of audio entertainment.

The home base device cart 1100 may be configured to map locations whereit may travel, either by input from a programmer or by learning thesurrounding area. This will allow the home base device cart 1100 to beable determine paths of travel and obstacles. Particular locations onthe map may be labeled, such as home, second floor, or yard. The homebase device cart 1100 may be designed to for maximum silence, such thatit will not disturb a patient.

The home base device cart 1100 may comprise a HBD mount 1102. The HBDmount 1102 may be configured to hold the HBD 154 and to communicativelycouple the HBD 154 to the home base device cart 1100, such that the HBD154 may utilize the features of the home base device cart 1100. The HBD154 may be physically held in place by a lip 1104 that may be engagedusing locking switch 1114. To prevent damage to the HBD 154 and homebase device cart 1100 from elements, the lip 1104 may be designed to bewatertight and resistant to spills.

The home base device cart 1100 may have optical sensor tracks 1110 alongthe edges of the top of the cart, such that the home base device cart1100 may be able to identify objects above the cart helping the cart tofind locations that are out of sight to stop. The optical sensor tracks1110 may assist the home base device cart 1100 in mapping its physicalsurrounding. The optical sensor tracks 1110 may be used to determinewhich audio input/output, depending on intended direction ofcommunication, should be utilized for optimal effect in communicatingwith the patient. The optical sensor tracks 1110 may be configured toidentify obstacles and react quickly to identified obstacles, almost asa reflex, to avoid damage to the cart or obstacles. The obstacles mayinclude animals, individuals, and the patient.

The home base device cart 1100 may have audio input/output 1112 used tocommunicate with the patient. The audio input/output 1112 may beaccessed by the HBD 154, such that the HBD 154 may use the audioinput/output 1112 to provide reminders to the patient. The audioinput/output 1112 may be configured to receive basic commands from apatient, such that the home base device cart 1100 or the HBD 154 mayrespond to the commands. The audio input/output 1112 may also beconfigured to provide entertainment options for the patient, comprisingjokes, music, news, digital books, and recorded speeches, among othertypes of audio entertainment. The audio input/output 1112 may be limitedto warning tones when the home base device cart 1100 is in motion.

The home base device cart 1100 may comprise LEDs 1106. The LEDs 1106 maybe configured to respond to the ambient light of the home base devicecart's 1100 surroundings. In an embodiment, where the ambient light islow, such as at night, the LEDs 1106 may dim such that the home basedevice cart 1100 will still be visible, but will not prevent a patientfrom falling asleep. In an embodiment, where the ambient light is high,such as during the day, the LEDs 1106 may brighten such that a patientwill be able to notice the cart. The LEDs 1106 may further be configuredto fluctuate the intensity of light emitted, such as flashing, when thehome base device cart 1100 is moving to help differentiate the LEDs 1106from other light sources such that a patient will recognize the light isbeing emitted from the home base device cart 1100, making the patientaware of its presence. In an embodiment, the LEDs 1106 may be configuredto dim when the home base device cart 1100 stops under a piece offurniture, or somewhere else that a patient or other individual isunlikely to travel, as there may be a lower chance of the home basedevice cart 1100 interfering with the patient moving around.

The home base device cart 1100 may comprise ambient light sensors 1108.The ambient light sensors 1108 may be configured to sense changes inambient light that may signify issues that a patient may experience. Inan embodiment, the ambient light sensors 1108 may sense lights beingturned on in the middle of the night, showing that the patient is notsleeping through the night. The ambient light sensors 1108 may becommunicatively coupled to the LEDs 1106, such that the LEDs 1106 mayrespond to changes in data obtained by the ambient light sensors 1108.

FIG. 12 is a side view of one example of a home base device cart layout.

The home base device cart 1100 may be designed to operate for extendedperiods of time on limited battery life. The home base device cart 1100may be configured to sound an audible low battery warning when batterycharge drops below a certain level. Additionally, the features of thehome base device cart 1100 may be configured to lose power when thebattery charge drops below a second certain level, but power may bemaintained to the HBD 154 such that it will still be able to operate.The home base device cart 1100 may have a wall charger 1204, such thatthe cart may be plugged into a wall outlet to charge. The home basedevice cart 1100 may have a solar charging strip 1206 such that the cartmay utilize ambient light within a room or light from the sun forenergy. The solar charging strip 1206 may comprise any existinglight-based charging technology now known or later developed that maysuit the conditions in which the home base device cart 1100 may operate.

The home base device cart 1100 may have optical sensor tracks 1110 alongthe edges of the top of the cart, such that the home base device cart1100 may be able to identify objects above the cart helping the cart tofind locations that are out of sight to stop. The optical sensor tracks1110 may assist the home base device cart 1100 in mapping its physicalsurrounding. The optical sensor tracks 1110 may be used to determinewhich audio input/output, depending on intended direction ofcommunication, should be utilized for optimal effect in communicatingwith the patient. The optical sensor tracks 1110 may be configured toidentify obstacles and react quickly to identified obstacles, almost asa reflex, to avoid damage to the cart or obstacles.

The home base device cart 1100 may have audio input/output 1112 used tocommunicate with the patient. The audio input/output 1112 may beaccessed by the HBD 154, such that the HBD 154 may use the audioinput/output 1112 to provide reminders to the patient. The audioinput/output 1112 may be configured to receive basic commands from apatient. The audio input/output 1112 may also be configured to provideentertainment options for the patient, comprising jokes, music, news,digital books, and recorded speeches, among other types of audioentertainment. The audio input/output 1112 may be limited to warningtones when the home base device cart 1100 is in motion.

The home base device cart 1100 may comprise LEDs 1106. The LEDs 1106 maybe configured to respond to the ambient light of the home base devicecart's 1100 surroundings. In an embodiment, where the ambient light islow, such as at night, the LEDs 1106 may dim such that the home basedevice cart 1100 will still be visible, but will not prevent a patientfrom falling asleep. In an embodiment, where the ambient light is high,such as during the day, the LEDs 1106 may brighten such that a patientwill be able to notice the cart. The LEDs 1106 may further be configuredto fluctuate the intensity of light emitted, such as flashing, when thehome base device cart 1100 is moving to help differentiate the LEDs 1106from other light sources such that a patient will recognize the light isbeing emitted from the home base device cart 1100, making the patientaware of its presence. In an embodiment, the LEDs 1106 may be configuredto dim when the home base device cart 1100 stops under a piece offurniture, or somewhere else that a patient or other individual isunlikely to travel, as there may be a lower chance of the home basedevice cart 1100 interfering with the patient moving around.

The home base device cart 1100 may comprise ambient light sensors 1108.The ambient light sensors 1108 may be configured to sense changes inambient light that may signify issues that a patient may experience. Inan embodiment, the ambient light sensors 1108 may sense lights beingturned on in the middle of the night, showing that the patient is notsleeping through the night. The ambient light sensors 1108 may becommunicatively coupled to the LEDs 1106, such that the LEDs 1106 mayrespond to changes in data obtained by the ambient light sensors 1108.

The home base device cart 1100 may have tires 1220 for mobility. Thetires 1220 may be heavy tread tires of solid construction, such that thetires may travel across all different types of surfaces and the tiresmay require minimal maintenance. The tires 1220 may be coupled to themain body of the home base device cart 1100 by legs 1216 and bearings1218. The bearings 1218 may be configured to move independent to eachother bearing on the cart and allow for maximum rotation angles foroptimal range of mobility. The home base device cart 1100 may beconfigured to adjust height of the unit and move on two wheels in astable manner to circumvent obstacles.

The home base device cart 1100 may comprise a wireless device 1202. Thewireless device 1202 may be used to locate the home base device cart1100 in the event of an emergency. The home base device cart 1100 maycontact emergency services and transmit its location, such as a beacon,to the emergency services, such that the emergency services will be ableto determine the location of the patient and provide the patient care inthe situation where the patient may not be able to contact emergencyservices on her own. For example, diabetics and Alzheimer's patientswith diminished capacity medical conditions may be in a state where theyare not fully in control of their actions and the home base device cart1100 may be able to contact emergency services to obtain care for thepatient. In an embodiment, if the home base device cart 1100 shouldcease to function, the HBD 154 may operate as a beacon signifying thepatient's location. The wireless function may be limited to an emergencybeacon or to tap into GPS services to navigate back to a home base oralert in the event that it moves beyond a point that may indicate thatthe patient may be in crisis or about to enter crisis.

In an embodiment, the wireless device 1202 may be used to locate arecharging location, such that the home base device cart 1100 may travelto the recharging location to wirelessly recharge its battery. Therecharging location may be within a proximity to a table rechargingstation or a floor recharging station, among other rechargingtechnologies that may be utilized by the home base device cart 1100.

It will be apparent to those having skill in the art that many changesmay be made to the details of the above-described examples withoutdeparting from the underlying principles of the invention. The scope ofthe present invention should, therefore, be determined only by thefollowing claims.

Most of the equipment discussed above comprises hardware and associatedsoftware. For example, the typical portable device is likely to includeone or more processors and software executable on those processors tocarry out the operations described. We use the term software herein inits commonly understood sense to refer to programs or routines(subroutines, objects, plug-ins, etc.), as well as data, usable by amachine or processor. As is well known, computer programs generallycomprise instructions that are stored in machine-readable orcomputer-readable storage media. Some embodiments of the presentinvention may include executable programs or instructions that arestored in machine-readable or computer-readable storage media, such as adigital memory. We do not imply that a “computer” in the conventionalsense is required in any particular embodiment. For example, variousprocessors, embedded or otherwise, may be used in equipment such as thecomponents described herein.

Memory for storing software again is well known. In some embodiments,memory associated with a given processor may be stored in the samephysical device as the processor (“on-board” memory); for example, RAMor FLASH memory disposed within an integrated circuit microprocessor orthe like. In other examples, the memory comprises an independent device,such as an external disk drive, storage array, or portable FLASH keyfob. In such cases, the memory becomes “associated” with the digitalprocessor when the two are operatively coupled together, or incommunication with each other, for example by an I/O port, networkconnection, etc. such that the processor can read a file stored on thememory. Associated memory may be “read only” by design (ROM) or byvirtue of permission settings, or not. Other examples include but arenot limited to WORM, EPROM, EEPROM, FLASH, etc. Those technologies oftenare implemented in solid state semiconductor devices. Other memories maycomprise moving parts, such as a conventional rotating disk drive. Allsuch memories are “machine readable” or “computer-readable” and may beused to store executable instructions for implementing the functionsdescribed herein.

A “software product” refers to a memory device in which a series ofexecutable instructions are stored in a machine-readable form so that asuitable machine or processor, with appropriate access to the softwareproduct, can execute the instructions to carry out a process implementedby the instructions. Software products are sometimes used to distributesoftware. Any type of machine-readable memory, including withoutlimitation those summarized above, may be used to make a softwareproduct. That said, it is also known that software can be distributedvia electronic transmission (“download”), in which case there typicallywill be a corresponding software product at the transmitting end of thetransmission, or the receiving end, or both.

Having described and illustrated the principles of the invention in apreferred embodiment thereof, it should be apparent that the inventionmay be modified in arrangement and detail without departing from suchprinciples. We claim all modifications and variations coming within thespirit and scope of the following claims.

1. A method, comprising: at a secure portable medical assistant device(PMAD), receiving and storing information associated with a patient; atthe PMAD, displaying a first portion of the received information,wherein the first portion comprises the patient's name and directions tothe patient's domicile; and at the PMAD, displaying a second portion ofthe received information only while the PMAD is located within aphysical proximity to a home base device, wherein the home base deviceis associated with the patient and located at the patient's domicile,and the second portion specifies a medical procedure to be performed forthe patient by a specific healthcare provider at the patient's domicile.2. The method of claim 1, further comprising: at the PMAD, savingdiagnostic information associated with the patient; and securelytransmitting the diagnostic information from the PMAD to a centralserver.
 3. The method of claim 1, further comprising providing a warningresponsive to the PMAD location moving outside the physical proximity.4. The method of claim 1, further comprising: at the PMAD, requiringlogin authentication of the specific healthcare provider prior todisplay of any portion of the received information; and transmitting analert to a central server in response to an input of improper logincredentials to the PMAD.
 5. The method of claim 1, further comprisingsecurely transmitting a notification to a central server that the PMADis within the physical proximity of the home base device.
 6. The methodof claim 5, wherein the notification comprises contact information forthe healthcare provider.
 7. The method of claim 5, further comprising:at the HBD, communicating with a local environmental sensor to acquiresensor data; at the HBD, transmitting the acquired sensor data to thePMAD for storage in the information associated with the patient.
 8. Amethod, comprising: storing health information for a patient; orderingservices to be performed for the patient; assigning the ordered servicesto a healthcare provider; securely transmitting services information toa portable medical assistant device (PMAD) associated with the assignedhealthcare provider; and securely transmitting at least a portion of thehealth information for the patient to the PMAD, wherein the portion isrelated to the services.
 9. The method of claim 8, wherein theassignment of a healthcare provider comprises selection of thehealthcare provider from a stored list of healthcare providers.
 10. Themethod of claim 8, further comprising: receiving diagnostic informationassociated with the patient; and storing the diagnostic information. 11.The method of claim 8, wherein the diagnostic information compriseschanges in the patient's condition or physical environment that mayindicate unsafe conditions; and wherein the method further comprisesalerting a medical facility of the changes in the patient's condition orthe physical environment.
 12. The method of claim 8, further comprising:securely transmitting information to a home base device installed at alocation, wherein the information comprises pending healthcare providervisitation scheduling data.
 13. The method of claim 9, furthercomprising: receiving a request to alter the pending healthcare providervisitation scheduling data; and alerting a medical facility to thereceipt of the request to alter the pending healthcare providervisitation scheduling data.